Interventional procedures (including coronary angiography and angioplasty) are usually performed via transfemoral access. Although this route provides relatively easy vascular access, it is associated with several shortcomings.
First, such a route is difficult to implement with patients that have substantial peripheral artery disease (such as aortoileofemoral obstructive disease), abdominal aortic aneurysm, groin infection, or morbid obesity. Second, a small but potentially serious incidence of vascular complications at the puncture site that may result in significant groin hematoma, which could lead to necessary blood transfusions and/or require surgical repair.
A major advantage of the transfemoral route is puncturing the accessible and large caliber femoral arteries is relatively easy. Although first attempted two decades ago, the radial (transradial) approach is still more difficult to perform and has a higher failure attempt rate (1-9% in experienced hands) primarily due to the smaller size of the vessels, whereby the needle tip may over-perforate during the procedure. Accordingly, the transradial technique has a steep learning curve.
Accordingly, alternative methods, and devices for performing transradial access would be well received by interventional practitioners treating patients meeting one or more of the aforementioned criteria. As such, there is clearly a need for a needle access device that allows visualization of puncture through blood retrieval and that allows retraction of the needle tip to prevent overperforation.